School of Pharmacy, College of Health Sciences, Mekelle University, Mek'ele, Ethiopia.
Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Health Qual Life Outcomes. 2021 Jan 19;19(1):24. doi: 10.1186/s12955-021-01670-7.
Patients' health-related quality of life (HRQoL) and health state utility values are critical inputs in the clinical and economic evaluation of treatments for human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). However, information on health state utility values is lacking in the context of Ethiopia. Here, we aimed to assess HRQoL and determine health state utility values and factors that influence the values among HIV/AIDS patients in Ethiopia.
A cross-sectional study was conducted among 511 HIV/AIDS patients at Tikur Anbessa Specialized Hospital in Ethiopia. Patients aged 18 years or older were eligible for the interview and those who were mentally unstable and with hearing impairment were excluded from the study. We performed face-to-face interviews using EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) in combination with EuroQol-Visual Analog Scales (EQ-VAS). Level-specific disutility coefficients obtained from the general population were used for computing utility values. Patients' health profiles were described using percentages and different statistical analysis were conducted to determine factors associated with the EQ-5D index and EQ-VAS scores.
A total of 511 patients participated in the study. A higher proportion of patients reported slight or more severe problems on the anxiety/depression (55.2%) and pain/discomfort (51.3%) dimensions. The overall median utility value of HIV/AIDS patients was 0.94 (IQR = 0.87, 1) from the EQ-5D index and 80% (IQR = 70%, 90%) from the EQ-VAS scores. Demographic characteristics including age, occupational status, and household monthly income significantly affected patient's utility values. Moreover, statistically significant (p < 0.001) differences were seen between the EQ-5D index values of patients with different CD4 count intervals. Furthermore, number of medicines that the patients were taking at the time of the study and comorbidities were significantly associated with the EQ-5D utility index and EQ-VAS score, p < 0.001.
The anxiety/depression and pain/ discomfort dimensions were identified to have critical influence in reducing the HRQoL of adult HIV/AIDS patients in the context of Ethiopia. The study is also the first to use the EQ-5D-5L tool to identify health state utility values for Ethiopian adult HIV/AIDS patients. Future economic evaluations of HIV/AIDS interventions are encouraged to employ the identified utility values.
患者的健康相关生活质量（HRQoL）和健康状态效用值是评估人类免疫缺陷病毒（HIV）/获得性免疫缺陷综合征（AIDS）治疗的临床和经济效果的关键指标。然而，在埃塞俄比亚，有关健康状态效用值的信息尚缺乏。本研究旨在评估 HRQoL，并确定 HIV/AIDS 患者的健康状态效用值及其影响因素。
在埃塞俄比亚提克里安贝萨专科医院对 511 名 HIV/AIDS 患者进行了横断面研究。年龄在 18 岁及以上的患者有资格接受访谈，而那些精神不稳定和听力受损的患者则被排除在研究之外。我们使用欧洲五维健康量表-5 维度（EQ-5D-5L）与欧洲五维健康量表视觉模拟量表（EQ-VAS）相结合，对患者进行了面对面访谈。使用来自一般人群的特定维度失能系数来计算效用值。采用百分比描述患者的健康状况，并进行不同的统计分析，以确定与 EQ-5D 指数和 EQ-VAS 评分相关的因素。
共有 511 名患者参加了这项研究。较高比例的患者报告在焦虑/抑郁（55.2%）和疼痛/不适（51.3%）维度上存在轻微或更严重的问题。HIV/AIDS 患者的总体中位数效用值为 EQ-5D 指数的 0.94（IQR=0.87，1）和 EQ-VAS 评分的 80%（IQR=70%，90%）。人口统计学特征，包括年龄、职业状况和家庭月收入，显著影响了患者的效用值。此外，不同 CD4 计数间隔的患者 EQ-5D 指数值之间存在显著差异（p<0.001）。此外，研究时患者服用的药物数量和合并症与 EQ-5D 效用指数和 EQ-VAS 评分显著相关（p<0.001）。
在埃塞俄比亚的背景下，焦虑/抑郁和疼痛/不适维度被认为对降低成人 HIV/AIDS 患者的 HRQoL 具有重要影响。该研究也是首次使用 EQ-5D-5L 工具来确定埃塞俄比亚成人 HIV/AIDS 患者的健康状态效用值。鼓励对 HIV/AIDS 干预措施进行未来的经济评估，以采用所确定的效用值。
